American Journal of Drug and Alcohol Abuse最新文献

{"title":"Interactive effects between pregnancy-related alcohol policies and state spirits availability on infant and maternal outcomes.","authors":"Alex Schulte, Meenakshi S Subbaraman, Guodong Liu, William C Kerr, Pamela J Trangenstein, Sarah C M Roberts","doi":"10.1080/00952990.2025.2503459","DOIUrl":"10.1080/00952990.2025.2503459","url":null,"abstract":"<p><p><i>Background:</i> Most state policies targeting pregnant people's alcohol use are ineffective, while some broader alcohol availability policies like government monopolies on retail spirits sales are effective. Previous research has not explored interactions of these policies.<i>Objective:</i> Analyze whether there are interactive effects between pregnancy-specific alcohol policies and government monopolies over retail spirits sales on infant and maternal outcomes.<i>Methods:</i> Outcome data were from Merative MarketScan®, a commercial insurance claims database, and included individuals who birthed singletons between 2006 and 2019 (<i>N</i> = 1,432,979 birthing person-infant pairs). We examined interactions between six pregnancy-specific policies and government monopolies. Regression models include (monopolyXpregnancy-specific policy) interaction terms, state and year fixed-effects, state-specific time trends, individual- and state-level controls, and clustering by state.<i>Results:</i> Associations of pregnancy-specific policies were generally stronger, or only present, in monopoly states. However, there was no consistent pattern regarding direction. Conversely, government monopolies consistently related to reduced infant maltreatment, with the largest effect when Priority Treatment for pregnant women policies were also in place [-1.64% (95% CI -1.87, -1.41)]. Protective associations of government monopolies on infant morbidities differed across reporting policies; for example, monopolies were protective without Reporting Requirements for child welfare [-0.28% (95% CI -0.40, -0.17)], but no longer protective with this policy [0.00% (95% CI -0.53, 0.55)].<i>Conclusions:</i> Government monopolies on retail spirits sales generally relate to reduced infant maltreatment and morbidities, although some pregnancy-specific alcohol policies blunt the protective effects of government monopolies. Repealing some ineffective pregnancy-specific policies - e.g. some Reporting Requirements - in monopoly states might improve infant outcomes.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"471-483"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early experiences and impacts of a fentanyl powder safer supply program in Vancouver, Canada: a qualitative study.","authors":"Andrew Ivsins, Christy Sutherland, Thomas Kerr, Mary Clare Kennedy","doi":"10.1080/00952990.2025.2497800","DOIUrl":"10.1080/00952990.2025.2497800","url":null,"abstract":"<p><p><i>Background:</i> North America is experiencing an unrelenting overdose crisis driven by a volatile and toxic unregulated drug supply. Safer supply programs, which provide individuals with pharmaceutical-grade alternatives to the unregulated drug supply, have been implemented in various Canadian jurisdictions. While most programs provide tablet hydromorphone, the Safer Alternatives for Emergency Response (SAFER) program in Vancouver, Canada, offers pharmaceutical-grade fentanyl, including a powder formulation for witnessed consumption.<i>Objectives:</i> To explore early experiences among SAFER program participants receiving powder fentanyl.<i>Methods:</i> Qualitative one-on-one interviews were conducted with 18 (12 men, 6 women) people prescribed fentanyl powder from the SAFER program. Interview coding and analysis involved a team-based approach to identify common themes related to program experiences, focusing on impacts on unregulated drug use.<i>Results:</i> Most (13/18; 72%) participants reported reducing unregulated drug use since program enrollment. This was largely attributed to the SAFER fentanyl powder being effective for managing withdrawal, thereby limiting their need to access street-purchased drugs. Additionally, some participants, particularly those prescribed higher doses, suggested that SAFER fentanyl powder, unlike other safe supply medications, was a suitable alternative to street-purchased fentanyl. Participants also reported reduced overdose risk. Operating hours and dosing challenges were barriers to program engagement contributing to continued unregulated drug use for some.<i>Conclusion:</i> Our findings demonstrate a number of positive outcomes of the SAFER program and suggest that fentanyl safer supply has the potential to play a useful role in addressing the ongoing overdose crisis.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"492-501"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>In utero</i> chronic cannabis exposure is associated with lower total brain volume in the first month of postnatal life.","authors":"Tessa L Crume, Pilyoung Kim, Xinyi Shen, Erika Iisa, Marilyn A Huestis, Peter Fried, Elaine H Stickrath, Christine Conageski, Jocelyn E Phipers, Gregory Kinney, Cristina Sempio, Jost Klawitter, Alexander J Dufford","doi":"10.1080/00952990.2025.2506112","DOIUrl":"10.1080/00952990.2025.2506112","url":null,"abstract":"<p><p><i>Background:</i> I<i>n utero</i> cannabis exposure is associated with deleterious offspring neural development and behaviors that emerge across the lifespan. We explored if brain morphology differed in neonates exposed and unexposed to cannabis <i>in utero</i> in the first month of life.<i>Objective:</i> To evaluate differences in global and subcortical regional brain volume (in the amygdala and hippocampus) in neonates in the first month of life according to <i>in utero</i> cannabis exposure.<i>Methods:</i> Prospective pre-birth prospective cohort study of mother-infant pairs selected on the basis of prenatal cannabis use in the absence of alcohol, tobacco, or illegal drug use. The presence of cannabinoids using ultra-high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) was quantified in maternal and neonatal biological samples. Neonatal MRI was conducted to evaluate differences in global and subcortical brain morphology between the exposed and unexposed infants (18 exposed, 21 unexposed). Inverse probability of treatment weighting was utilized in a generalized linear model framework to remove structural confounding bias between exposure groups. Clinical Trial Registration: NCT03718520.<i>Results:</i> The sex distribution of neonates was 43% female. Neonates exposed to cannabis <i>in utero</i> had significantly lower total brain volume (estimated effect size = 26,496.90 mm³, <i>p</i> = .02), independent of confounders including maternal stress, compared to unexposed infants. The unadjusted difference in brain volume was 29,159.82 mm³, <i>p</i> = .05). Regional volumetric differences were not detected in the amygdala or hippocampus.<i>Conclusion:</i> Given the evidence of the adverse effects of exogenous cannabinoids on fetal brain development, it is vital to prioritize prevention and cessation efforts targeting pregnant women.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"458-470"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily drinking intention-behavior discrepancies are associated with drinking-related consequences.","authors":"Emily Junkin, Karolina Kazlauskaite, Cathy Lau-Barraco","doi":"10.1080/00952990.2025.2454405","DOIUrl":"10.1080/00952990.2025.2454405","url":null,"abstract":"<p><p><i>Background:</i> Unplanned drinking episodes are empirically and conceptually linked with adverse outcomes, though recent research suggests planned drinking episodes may be riskier. Mixed findings may be due to unplanned drinking being operationalized as a dichotomous representation of the phenomenon (e.g. was drinking planned or unplanned) rather than continuous (e.g. the number of drinks beyond one's intended limit). Examining a continuous representation of the number of unplanned drinks consumed (i.e. consumed minus intended drinks) would permit a more nuanced evaluation of unplanned drinking and may be more predictive of consequences.<i>Objectives:</i> The present study aimed to describe the occurrence of unplanned drinking and disentangle the role of dichotomous vs. continuous operationalizations in predicting consequences.<i>Methods:</i> Participants were 104 (81.7% female; <i>M_age</i> = 20.75, <i>SD</i> = 1.99) undergraduate drinkers recruited through a psychology subject pool. Participants completed an online baseline survey followed by 14 brief, daily online surveys. Daily reports yielded an analytic sample of 325 drinking episodes.<i>Results:</i> Results indicated that most drinking episodes were planned but underestimated in quantity (i.e. consumption exceeded intentions). Only the continuous estimate of unplanned drinking was associated with negative consequences after controlling for dichotomous unplanned drinking (<i>b</i> = 0.25, IRR = 1.28).<i>Conclusions:</i> Results shed light on the need for a more nuanced operationalization of unplanned drinking behaviors, as current research utilizing a dichotomous lens may not be fully capturing the risky phenomenon. Results suggest that unplanned drinking, particularly related to consuming more drinks than intended, may be a useful indicator of problematic drinking.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"308-316"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid use disorder Cascade of Care: defining a taxonomy for measurement.","authors":"Brandy F Henry, Noa Krawczyk, Ashly E Jordan, Chinazo O Cunningham, Pat Lincourt, Shazia Hussain, Charissa Fotinos, Arthur Robin Williams","doi":"10.1080/00952990.2025.2494106","DOIUrl":"10.1080/00952990.2025.2494106","url":null,"abstract":"<p><p><i>Background:</i> The opioid use disorder Cascade of care (OUD Cascade) is a public health framework used by federal/state/other agencies and researchers to facilitate monitoring and evaluating responses to the opioid epidemic, including surveillance and performance evaluation. As the use of the framework proliferates, there is an urgent need to standardize stage definitions to accurately monitor and improve patient outcomes and to align interpretation of findings across settings.<i>Objectives:</i> Define a taxonomy to uniformly apply the OUD Cascade to improve delivery of OUD services and better compare patient outcomes across settings and populations.<i>Methods:</i> We conducted a narrative review and synthesis focused on research and guidelines defining and measuring four key OUD Cascade stages: OUD identification, service engagement, medication initiation, and retention. Included articles come from peer-reviewed literature and define and/or operationalize OUD Cascade stages and associated measures across six characteristics based on an adaptation of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist including: 1) settings, 2) specific population, 3) perspective, 4) time horizon, 5) assumptions, and 6) analytic method.<i>Results:</i> Our review (<i>n</i> = 27 articles) and synthesis provide an overview of how OUD Cascade definitions and framework designs have been variously applied. We found considerable heterogeneity in study approaches for all four OUD Cascade stages. We define a taxonomy to guide future research emphasizing standardized definitions to harmonize efforts across settings. In particular, we emphasize the need for clarity in defining criteria for sample construction (i.e. Identification), clear distinctions between receipt of care services generally (i.e. Engagement) from MOUD Initiation specifically, and Retention definitions that use a 30+ day gap in treatment to define discontinuation.<i>Conclusion:</i> Establishing a shared taxonomy for key terms specifying OUD Cascade stages will help the field advance, compare approaches and results across settings, and improve population-level patient outcomes.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"276-289"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulation of HDL metabolism in alcohol-associated liver disease: the role of HIF-1α and miR-185 in SR-BI suppression.","authors":"Jiye Zhang, Wenling Mou, Shiru Chen, Zhenting Wu, Shujie Zhang, Ping Liu, Haobo Sun, Hang Zhou, Ying Liu","doi":"10.1080/00952990.2025.2506529","DOIUrl":"10.1080/00952990.2025.2506529","url":null,"abstract":"<p><p><i>Background:</i> Alcohol-associated liver disease (ALD) results from excessive alcohol consumption, leading to liver damage such as steatosis and inflammation. Hypoxia and altered lipid metabolism contribute to ALD pathogenesis. HIF-1α, a key hypoxia regulator, and miR-185, a microRNA associated with ALD, are potential contributors to the disease.<i>Objectives:</i> To explore how HIF-1α and miR-185 regulate SR-BI and HDL metabolism in ethanol-exposed hepatocytes and their role in ALD-related lipid dysfunction.<i>Methods:</i> HL-7702 cells were treated with ethanol (25-200 mm) or hypoxia (1-2% O₂) for 24-72 hours to identify optimal conditions. miR-185 or HIF-1α inhibitors were used to assess SR-BI expression. Co-localization of HIF-1α and SR-BI was evaluated by immunofluorescence, and high-density lipoprotein cholesterol (HDL-C), which is critical in lipid metabolism, and triglyceride (TG) levels were measured by ELISA.<i>Results:</i> Ethanol exposure reduced cell viability in a dose- and time-dependent manner (200 mm for 72 h reduced viability by 43.7% ± 4.1%, <i>p</i> = .003). Exposure to 1% oxygen for 72 hours was confirmed as the optimal hypoxia model. Ethanol (200 mm) or hypoxia significantly increased HIF-1α (<i>p</i> = .002) and miR-185 expression (<i>p</i> = .001). These changes were accompanied by reduced SR-BI expression and elevated HDL-C and TG levels. miR-185 knockdown restored SR-BI expression (<i>p</i> = .003) and normalized HDL-C (<i>p</i> = .004) and TG levels (<i>p</i> = .005).<i>Conclusions:</i> Ethanol-induced HIF-1α and miR-185 upregulation disrupts HDL metabolism by suppressing SR-BI, impairing hepatic HDL uptake in ALD. Targeting this axis may offer new therapeutic strategies for ALD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"447-457"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale longitudinal analysis of the progression of alcohol use among members of a social media platform: an observational study.","authors":"Fernanda C Andrade, William U Meyerson, Rick H Hoyle","doi":"10.1080/00952990.2024.2414324","DOIUrl":"10.1080/00952990.2024.2414324","url":null,"abstract":"<p><p><i>Background:</i> The large-scale identification of people at risk of transitioning from relatively lower-risk to higher-risk alcohol use (e.g. problem drinking) remains a public health challenge despite advances in the identification of risk and protective factors.<i>Objective:</i> This observational study used machine learning to identify Reddit (social media platform) posting activity associated with transitioning from lower- to higher-risk forms of alcohol use.<i>Methods:</i> We employed bottom-up and top-down approaches to identify lower- and higher-risk alcohol-related subreddits. Using a non-parametric negative control procedure, we estimated each of 10,006 Reddit communities' risk of progression from lower- to higher-risk alcohol-related communities and applied a random forest model to predict progression among individual Reddit members. Eligible Reddit members had posted on Reddit for two or more years before their first post in a lower-risk alcohol-related community and for three or more years after that (<i>N</i> = 4,160).<i>Results:</i> Our methodology identified 42 alcohol-related communities, four of which were suggestive of problem drinking. Five communities were significantly associated with progression. Random forests model's risk scores for individual members correlated with their progression to higher-risk communities at 0.30; the model predicted progression of individual Reddit members with a 0.92 area under the curve.<i>Conclusions:</i> Posting in communities dedicated to other substance use, depression, and occupation in the food service industry was associated with posting activity suggestive of problem drinking 3 years later. Posting activity on Reddit may be used for early detection of people at higher risk of transitioning from lower- to higher-risk forms of alcohol use.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12533264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New therapeutics for the prevention or amelioration of fetal alcohol spectrum disorders: a narrative review of the preclinical literature.","authors":"Montserrat Olivares-Costa, María Carolina Fabio, Erwin De la Fuente-Ortega, Paola A Haeger, Ricardo Pautassi","doi":"10.1080/00952990.2024.2361442","DOIUrl":"10.1080/00952990.2024.2361442","url":null,"abstract":"<p><p><i>Background:</i> Ethanol consumption during pregnancy induces enduring detrimental effects in the offspring, manifesting as a spectrum of symptoms collectively termed as Fetal Alcohol Spectrum Disorders (FASD). Presently, there is a scarcity of treatments for FASD.<i>Objectives:</i> To analyze current literature, emphasizing evidence derived from preclinical models, that could potentially inform therapeutic interventions for FASD.<i>Methods:</i> A narrative review was conducted focusing on four prospective treatments: nutritional supplements, antioxidants, anti-inflammatory compounds and environmental enrichment. The review also highlights innovative therapeutic strategies applied during early (e.g. folate administration, postnatal days 4-9) or late (e.g. NOX2 inhibitors given after weaning) postnatal stages that resulted in significant improvements in behavioral responses during adolescence (a critical period marked by the emergence of mental health issues in humans).<i>Results:</i> Our findings underscore the value of treatments centered around nutritional supplementation or environmental enrichment, aimed at mitigating oxidative stress and inflammation, implying shared mechanisms in FASD pathogenesis. Moreover, the review spotlights emerging evidence pertaining to the involvement of novel molecular components with potential pharmacological targets (such as NOX2, MCP1/CCR2, PPARJ, and PDE1).<i>Conclusions:</i> Preclinical studies have identified oxidative imbalance and neuroinflammation as relevant pathological mechanisms induced by prenatal ethanol exposure. The relevance of these mechanisms, which exhibit positive feedback loop mechanisms, appear to peak during early development and decreases in adulthood. These findings provide a framework for the future development of therapeutic avenues in the development of specific clinical treatments for FASD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"749-770"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations in surface-based brain morphometry in men with opioid use disorder.","authors":"Abhishek Ghosh, Abhishek Verma, Simranjit Kaur, Chirag K Ahuja, Ritu Nehra, Paramjit Singh, Manish Modi, Debasish Basu","doi":"10.1080/00952990.2024.2417220","DOIUrl":"10.1080/00952990.2024.2417220","url":null,"abstract":"<p><p><i>Background:</i> Cortical differences in thickness, folding, and complexity may reflect synaptic pruning and myelination alterations. Individuals with opioid use disorder (OUD) may demonstrate differences in these cortical metrics due to neurodevelopmental aberrations or early opioid exposure.<i>Objectives:</i> We compared the cortical metrics between individuals with OUD and controls. The influence of age and duration of opioid exposure were considered indirect evidence for preexisting or opioid-exposure-based structural aberrations.<i>Methods:</i> Sixty-nine treatment-naïve men with OUD (52 heroin, 17 non-heroin) and 25 age and education-matched non-drug-using male controls were recruited from a treatment center and community, respectively. 3-Tesla Siemens Magnetom Verio scanner and Computational Anatomy Toolbox 12 were used for image acquisition and processing. Cortical parcellation was performed using Destrieux atlas. Surface-based morphometry (SBM) metrics were cortical thickness, sulcal depth, fractal dimension, and gyrification index.<i>Results:</i> Only two cortical areas survived corrections for multiple comparisons: persons with OUD had greater sulcal depth in the right lateral orbital sulcus (<i>p</i> = .0003, Glass's delta = 0.98) and lower gyrification index in the left frontal middle gyrus (<i>p</i> = .0005, Glass's delta = 0.67) than controls. The group-by-age interaction effect on the cortical thickness was non-significant. Lower age of initiation of opioid use was associated with larger cortical thickness in the inferior frontal (<i>r</i> = -0.36, <i>p</i> = .002) and anterior cingulate (<i>r</i> = -0.35, <i>p</i> = .003) regions. Duration of OUD negatively correlated with cortical thickness in frontal and occipital areas (<i>r</i> > -.30, <i>p</i> = .004-.007).<i>Conclusion:</i> Cortical abnormalities may stem from altered synaptic pruning and myelination, possibly due to neurodevelopmental aberrations or early opioid exposure.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"819-830"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital cognitive-behavioral therapy for substance use: systematic review and meta-analysis of randomized controlled trials.","authors":"Virgil Lee Gregory, David A Wilkerson, Samantha N Wolfe-Taylor, Breena L Miller, Alexander D Lipsey","doi":"10.1080/00952990.2024.2400934","DOIUrl":"10.1080/00952990.2024.2400934","url":null,"abstract":"<p><p><i>Background:</i> Prior meta-analyses have evaluated digital interventions for alcohol exclusively and alcohol/tobacco combined. These meta-analyses showed positive outcomes pertaining to alcohol and alcohol/tobacco combined. Yet questions remain pertaining to the effect of digital cognitive-behavioral therapy (CBT) on reducing alcohol and drug use.<i>Objectives:</i> The purpose of the meta-analysis was to determine the mean effect size, relative to control groups, of digital CBT, for posttest reductions in drug and/or alcohol use.<i>Methods:</i> The Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria was used to guide this review and meta-analysis. Electronic databases (APA PsycArticles, Academic Search Complete, APA PsycInfo, CINAHL Complete, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, Social Sciences Full Text, Social Work Abstracts, SocINDEX), clinicaltrials.gov, reference lists were searched. The protocol was registered in PROSPERO (ID#: CRD42023471492). The CBT interventions included cognitive restructuring.<i>Results:</i> All but one of the effect sizes favored digital CBT (from -0.02 to -1.45). After the removal an outlier, a small, significant, random effects model Hedges' <i>g</i> summary effect of -0.23 (95% confidence interval: -0.32, -0.14, <i>p</i> < .0001) showed a reduction in substance use at the posttest, favoring digital CBT relative to the control group. A variety of control conditions were used; however, the effects sizes had minimal heterogeneity (<i>k</i> = 17, <i>I</i>² = 5.34, <i>Q</i> = 16.9, <i>p</i> = .39). The funnel plot and Egger regression test intercept (0.01, <i>p</i> = .99) lacked publication bias.<i>Conclusion:</i> The meta-analytic findings suggest digital CBT is an efficacious treatment for reducing alcohol and drug use overall.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"771-785"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}